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Banerjee S, Netaji J, Gupta A, Gahlot N, Barwar N, Elhence A. Perception of telemedicine among orthopedic surgeons and patients and an analysis of the factors governing its overall efficacy: Results from the COVID-19 pandemic. Indian J Public Health 2023; 67:422-427. [PMID: 37929385 DOI: 10.4103/ijph.ijph_1732_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Background Providing health-care services through telemedicine for musculoskeletal ailments after the first wave of COVID-19 may help reduce the burden on the already-strained health-care system. Objectives The objectives of this study were (1) to assess the satisfaction levels of orthopedic surgeons and patients with respect to telemedicine and (2) to determine the factors governing the overall efficacy of telemedicine consultations. Materials and Methods A cross-sectional study was conducted to ascertain the perception of telemedicine (both doctors and patients) under the following domains - (1) information provided and ease of usage; (2) doctor-patient communication; (3) ease of prescribing and understanding treatment; and (4) audio-video quality of the consultation. The influence of these factors on overall satisfaction was determined using multinomial logistic regression analysis. Results Of the 204 patients and 27 surgeons who completed the questionnaire, 77% (patients) and 89% (surgeons) were satisfied with the overall efficacy of telemedicine. Maximum satisfaction was noted with the ease of obtaining a telemedicine appointment (168/204). 68.6% of patients further stated they would prefer future visits virtually. While all four factors were found to have a significant correlation (P < 0.001) with the overall efficacy of teleconsultation services, the quality of the telephone call (odds ratio [OR] =90.15) and good doctor-patient communication (OR = 15.5) were found to be the most important of the lot. Conclusion Our study not only demonstrates the high degree of satisfaction with telehealth services but is also able to pinpoint the areas where improvement is needed to enhance the overall experience with this technology.
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Affiliation(s)
- Sumit Banerjee
- Additional Professor, Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Jeshwanth Netaji
- Senior Resident, Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Akshat Gupta
- Senior Resident, Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Nitesh Gahlot
- Associate Professor, Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Nilesh Barwar
- Associate Professor, Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Abhay Elhence
- Professor, Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Sabetian PW, Ouyang VW, Fox JD, Jimenez AE, Ankem HK, Saks BR, Maldonado DR, Lall AC, Domb BG. Telemedicine: An Effective Tool for Patient-Physician Communication. Orthopedics 2023; 46:e173-e178. [PMID: 36623281 DOI: 10.3928/01477447-20230104-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The purpose of this study was to evaluate the effectiveness of telemedicine appointments in a tertiary orthopedic hip clinic during the COVID-19 pandemic, as a substitute for traditional in-person visits. One hundred sixty-three patients had a telemedicine visit from March to September 2020. Patients were divided into two cohorts. The presurgical group included all patients who had not undergone any prior surgical hip procedures. The pre-surgical group was further subdivided into two groups based on the purpose of the visit: conservative treatment and imaging review. Patients who were indicated for surgical treatment from these two groups were identified to assess their compliance with the surgical indication. The effectiveness was measured by assessing whether patients required an in-person visit before the scheduled follow-up after the telemedicine visit for further medical assessment. Fifty (30.7%) men and 113 (69.3%) women had a telemedicine visit during the 6-month period. The mean age was 43.68 (±16.95) years. There were 92 (56.4%) patients in the presurgical group, of whom 41% followed up after indication for conservative treatment and 59% visited to review imaging. From these groups, 27% were indicated for surgical treatment. The postsurgical group contained 71 (43.6%) patients, divided into three groups based on their surgery date: 0 to 3 months (27%), 4 to 12 months (59%), and more than 12 months (14%). All patients were compliant with the scheduled follow-up after their telemedicine visit. This study showed that telemedicine can be an effective tool for patient-physician communication, obviating the need for subsequent follow-up beyond regularly scheduled visits. [Orthopedics. 20XX;XX(X):xx-xx.].
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Ford JH, Jolles SA, Heller D, Langenstroer M, Crnich C. There and back again: the shape of telemedicine in U.S. nursing homes following COVID-19. BMC Geriatr 2022; 22:337. [PMID: 35436869 PMCID: PMC9015887 DOI: 10.1186/s12877-022-03046-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/06/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Telemedicine use in nursing homes (NHs) expanded during the COVID-19 pandemic. The objectives of this study were to characterize plans to continue telemedicine among newly adopting NHs and identify factors limiting its use after COVID-19. Methods Key informants from 9 Wisconsin NHs that adopted telemedicine during COVID-19 were recruited. Semi-structured interviews and surveys were employed to identify participant perceptions about the value of telemedicine, implementation challenges encountered, and plans and barriers to sustaining its delivery after COVID-19. Directed content analysis and a deductive thematic approach using the Systems Engineering Initiative for Patient Safety (SEIPS) model was used during analyses. Quantitative and qualitative data were integrated to identify participant views on the value of telemedicine and the tools and work system enhancements needed to make telemedicine easier and more effective. Results All participating NHs indicated a preference to continue telemedicine after COVID-19. Urgent assessments of resident change-in-condition and cognitively based sub-specialty consultations were identified as the encounter types most amenable to telemedicine. Reductions in resident off-site encounters and minimization of resident therapy interruptions were identified as major benefits of telemedicine. Twelve work system enhancements needed to better sustain telemedicine were identified, including improvements to: 1) equipment/IT infrastructure; 2) scheduling; 3) information exchange; and 4) telemedicine facilitators. Discussion NHs that adopted telemedicine during COVID-19 wish to continue its use. However, interventions that enhance the integration of telemedicine into NH and off-site clinic work systems require changes to existing regulations and reimbursement models to sustain its utilization after COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03046-y.
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Affiliation(s)
- James H Ford
- Social & Administrative Sciences Division, School of Pharmacy, University of Wisconsin, 777 Highland Ave, Madison, WI, 53705, USA.
| | - Sally A Jolles
- University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Dee Heller
- University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | | | - Christopher Crnich
- University of Wisconsin School of Medicine & Public Health, Madison, WI, USA.,William S. Middleton VA Hospital, Madison, WI, USA
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Warmoth K, Lynch J, Darlington N, Bunn F, Goodman C. Using video consultation technology between care homes and health and social care professionals: a scoping review and interview study during COVID-19 pandemic. Age Ageing 2022. [PMCID: PMC8824765 DOI: 10.1093/ageing/afab279] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background the COVID-19 pandemic disproportionately affected care home residents’ and staffs’ access to health care and advice. Health and social care professionals adapted rapidly to using video consultation (videoconferencing) technology without guidance. We sought to identify enablers and barriers to their use in supporting care home residents and staff. Methods a scoping review of the evidence on remote consultations between healthcare services and care homes. Interviews with English health and social care professionals about their experiences during the pandemic. Findings were synthesised using the non-adoption, abandonment, scale-up, spread, sustainability framework. Results 18 papers were included in the review. Twelve interviews were completed. Documented enablers and barriers affecting the uptake and use of technology (e.g. reliable internet; reduced travelling) resonated with participants. Interviews demonstrated rapid, widespread technology adoption overcame barriers anticipated from the literature, often strengthening working relationships with care homes. Novel implementation issues included using multiple platforms and how resident data were managed. Healthcare professionals had access to more bespoke digital platforms than their social care counterparts. Participants alternated between platforms depending on individual context or what their organisation supported. All participants supported ongoing use of technologies to supplement in-person consultations. Conclusions the evidence on what needs to be in place for video consultations to work with care homes was partly confirmed. The pandemic context demolished many documented barriers to engagement and provided reassurance that residents’ assessments were possible. It exposed the need to study further differing resident requirements and investment in digital infrastructure for adequate information management between organisations.
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Affiliation(s)
- Krystal Warmoth
- Centre for Research in Public Health and Community Care (CRIPACC), University of Hertfordshire, AL10 9AB Hatfield, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration East of England, CB2 8AH Cambridge, UK
| | - Jennifer Lynch
- Centre for Research in Public Health and Community Care (CRIPACC), University of Hertfordshire, AL10 9AB Hatfield, UK
| | - Nicole Darlington
- Centre for Research in Public Health and Community Care (CRIPACC), University of Hertfordshire, AL10 9AB Hatfield, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration East of England, CB2 8AH Cambridge, UK
| | - Frances Bunn
- Centre for Research in Public Health and Community Care (CRIPACC), University of Hertfordshire, AL10 9AB Hatfield, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration East of England, CB2 8AH Cambridge, UK
| | - Claire Goodman
- Centre for Research in Public Health and Community Care (CRIPACC), University of Hertfordshire, AL10 9AB Hatfield, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration East of England, CB2 8AH Cambridge, UK
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Cherba M, Grosjean S, Bonneville L, Nahon-Serfaty I, Boileau J, Waldolf R. The essential role of nurses in supporting physical examination in telemedicine: Insights from an interaction analysis of postsurgical consultations in orthopedics. Nurs Inq 2021; 29:e12452. [PMID: 34428319 DOI: 10.1111/nin.12452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 07/27/2021] [Accepted: 08/01/2021] [Indexed: 12/28/2022]
Abstract
Telemedicine changes clinical practice and introduces new ways of distributing tasks between physicians and nurses, and particularly the delegation of sensory assessments during remote physical examinations. As nurses become more involved in patient assessment and clinical decision-making, the quality of physician-nurse collaboration has been recognized as essential to ensure quality patient care. However, few studies have examined physician-nurse interactions during teleconsultations. This article presents the results of an empirical study of nurse-physician communication during remote physical examinations. In partnership with a university-affiliated hospital in Ontario, Canada, we observed and recorded 10 simulated postsurgical consultations in orthopedics (involving a physician, a patient, and an on-site nurse) and conducted auto-confrontation interviews with physicians. The results of the thematic analysis of the interviews informed the selection of consultation sequences for in-depth interaction analysis. The findings demonstrate the nurse's essential role during remote physical examinations and reveal specific practices accomplished by the nurse to ensure successful nurse-physician collaboration. The interview data shows how physicians view the nurse's role and contributions. The findings contribute to our understanding of the collaborative nature of sensory assessments during remote physical examinations in telemedicine and can inform the development of training programs for professionals focusing on communication skills. Implications for clinical practice are discussed.
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Affiliation(s)
- Maria Cherba
- Department of Communication, University of Ottawa, Ottawa, Ontario, Canada
| | - Sylvie Grosjean
- Department of Communication, University of Ottawa, Ottawa, Ontario, Canada.,Institut du Savoir Montfort, Ottawa, Ontario, Canada
| | - Luc Bonneville
- Department of Communication, University of Ottawa, Ottawa, Ontario, Canada.,Institut du Savoir Montfort, Ottawa, Ontario, Canada
| | - Isaac Nahon-Serfaty
- Department of Communication, University of Ottawa, Ottawa, Ontario, Canada.,Institut du Savoir Montfort, Ottawa, Ontario, Canada
| | - Judith Boileau
- Department of Clinical Services, Hôpital Montfort, Ottawa, Ontario, Canada
| | - Richard Waldolf
- Institut du Savoir Montfort, Ottawa, Ontario, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Sahni M, Choudhry J, Mittal A, Bhogal G. Remote Musculoskeletal Consultations: A Survey of General Practitioner Registrars' Level of Confidence, Acceptability, and Management. Cureus 2021; 13:e15084. [PMID: 34150413 PMCID: PMC8209758 DOI: 10.7759/cureus.15084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background and objective The coronavirus disease 2019 (COVID-19) pandemic has accelerated the shift towards remote consultations in the medical field, including musculoskeletal (MSK) appointments. General practitioner (GP) registrars are now routinely conducting many MSK consultations remotely; however, very little is known of their level of confidence and satisfaction regarding this new and evolving scenario, or how this may impact patient management of patients. In this study, we aimed to understand GP registrars' level of confidence and satisfaction with respect to remote MSK consultations, and the perceived impact on patient management. Study design This study involved a cross-sectional online survey of GP registrars in the West Midlands, which was conducted in January 2021. Methods The survey asked for ranked responses to questions comparing face-to-face consulting methods with remote consulting, focusing on confidence, satisfaction, onward investigations, and referral activity. Statistical analysis was performed using the R software version 4.0.3. Results The overall survey response was 21.2% (n=312/1,471). Of the respondents, 85.9% of GP registrars had not received any training to prepare them for remote MSK consultations. GP registrars generally felt that they were more confident when treating patients face-to-face compared to remote consultations (p<0.001). This was true for general MSK complaints as well as specific assessments of the hand, shoulder, spine, hip, knee, and ankle; 36.2% of GP registrars were not satisfied and 51.0% thought that their patients were not satisfied with the current quality of remote MSK consultations. Of note, 77.6% of GP registrars said that they were more likely to request additional investigations, and 75.6% stated that they were more likely to refer patients to a specialist after a remote MSK consultation. Conclusion This study highlights the need for further training to better equip primary care doctors for remote MSK consultations. With tailored training, GP registrars could offer more streamlined remote patient care for MSK complaints.
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Affiliation(s)
- Manroy Sahni
- Family Medicine, Royal Wolverhampton NHS Trust, Wolverhampton, GBR
| | - Jamaal Choudhry
- Orthopaedics, Royal Wolverhampton NHS Trust, Wolverhampton, GBR
| | - Ankush Mittal
- Department of Public Health, City of Wolverhampton Council, Wolverhampton, GBR
| | - Gurjit Bhogal
- Physical Medicine and Rehabilitation, Centre for Musculoskeletal Medicine, Royal Orthopaedic Hospital, Birmingham, GBR
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Groom LL, McCarthy MM, Stimpfel AW, Brody AA. Telemedicine and Telehealth in Nursing Homes: An Integrative Review. J Am Med Dir Assoc 2021; 22:1784-1801.e7. [PMID: 33819450 DOI: 10.1016/j.jamda.2021.02.037] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/12/2021] [Accepted: 02/21/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Telemedicine and telehealth are increasingly used in nursing homes (NHs). Their use was accelerated further by the COVID-19 pandemic, but their impact on patients and outcomes has not been adequately investigated. These technologies offer promising avenues to detect clinical deterioration early, increasing clinician's ability to treat patients in place. A review of literature was executed to further explore the modalities' ability to maximize access to specialty care, modernize care models, and improve patient outcomes. DESIGN Whittemore and Knafl's integrative review methodology was used to analyze quantitative and qualitative studies. SETTING AND PARTICIPANTS Primary research conducted in NH settings or focused on NH residents was included. Participants included clinicians, NH residents, subacute patients, and families. METHODS PubMed, Web of Science, CINAHL, Embase, PsycNET, and JSTOR were searched, yielding 16 studies exploring telemedicine and telehealth in NH settings between 2014 and 2020. RESULTS Measurable impacts such as reduced emergency and hospital admissions, financial savings, reduced physical restraints, and improved vital signs were found along with process improvements, such as expedient access to specialists. Clinician, resident, and family perspectives were also discovered to be roundly positive. Studies showed wide methodologic heterogeneity and low generalizability owing to small sample sizes and incomplete study designs. CONCLUSIONS AND IMPLICATIONS Preliminary evidence was found to support geriatrician, psychiatric, and palliative care consults through telemedicine. Financial and clinical incentives such as Medicare savings and reduced admissions to hospitals were also supported. NHs are met with increased challenges as a result of the COVID-19 pandemic, which telemedicine and telehealth may help to mitigate. Additional research is needed to explore resident and family opinions of telemedicine and telehealth use in nursing homes, as well as remote monitoring costs and workflow changes incurred with its use.
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Affiliation(s)
- Lisa L Groom
- New York University Rory Meyers College of Nursing, New York, NY, USA.
| | | | | | - Abraham A Brody
- New York University Rory Meyers College of Nursing, New York, NY, USA; Hartford Institute for Geriatric Nursing, New York, NY, USA; Division of Geriatric Medicine and Palliative Care, Department of Internal Medicine, NYU Grossman School of Medicine, New York, NY, USA
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8
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Hajesmaeel-Gohari S, Bahaadinbeigy K. The most used questionnaires for evaluating telemedicine services. BMC Med Inform Decis Mak 2021; 21:36. [PMID: 33531013 PMCID: PMC7852181 DOI: 10.1186/s12911-021-01407-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/25/2021] [Indexed: 12/13/2022] Open
Abstract
Background Questionnaires are commonly used tools in telemedicine services that can help to evaluate different aspects. Selecting the ideal questionnaire for this purpose may be challenging for researchers. This study aims to review which questionnaires are used to evaluate telemedicine services in the studies, which are most common, and what aspects of telemedicine evaluation do they capture. Methods The PubMed database was searched in August 2020 to retrieve articles. Data extracted from the final list of articles included author/year of publication, journal of publication, type of evaluation, and evaluation questionnaire. Data were analyzed using descriptive statistics. Results Fifty-three articles were included in this study. The questionnaire was used for evaluating the satisfaction (49%), usability (34%), acceptance (11.5%), and implementation (2%) of telemedicine services. Among telemedicine specific questionnaires, Telehealth Usability Questionnaire (TUQ) (19%), Telemedicine Satisfaction Questionnaire (TSQ) (13%), and Service User Technology Acceptability Questionnaire (SUTAQ) (5.5%), were respectively most frequently used in the collected articles. Other most used questionnaires generally used for evaluating the users’ satisfaction, usability, and acceptance of technology were Client Satisfaction Questionnaire (CSQ) (5.5%), Questionnaire for User Interaction Satisfaction (QUIS) (5.5%), System Usability Scale (SUS) (5.5%), Patient Satisfaction Questionnaire (PSQ) (5.5%), and Technology Acceptance Model (TAM) (3.5%) respectively. Conclusion Employing specifically designed questionnaires or designing a new questionnaire with fewer questions and more comprehensiveness in terms of the issues studied provides a better evaluation. Attention to user needs, end-user acceptance, and implementation processes, along with users' satisfaction and usability evaluation, may optimize telemedicine efforts in the future.
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Affiliation(s)
- Sadrieh Hajesmaeel-Gohari
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Kambiz Bahaadinbeigy
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
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Dubin JM, Wyant WA, Balaji NC, Ong WL, Kettache RH, Haffaf M, Zouari S, Santillan D, Autrán Gómez AM, Sadeghi-Nejad H, Loeb S, Borin JF, Gomez Rivas J, Grummet J, Ramasamy R, Teoh JYC. Telemedicine Usage Among Urologists During the COVID-19 Pandemic: Cross-Sectional Study. J Med Internet Res 2020; 22:e21875. [PMID: 33031047 PMCID: PMC7647472 DOI: 10.2196/21875] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/06/2020] [Accepted: 09/24/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Prior to the COVID-19 pandemic, urology was one of the specialties with the lowest rates of telemedicine and videoconferencing use. Common barriers to the implementation of telemedicine included a lack of technological literacy, concerns with reimbursement, and resistance to changes in the workplace. In response to the COVID-19 pandemic declared in March 2020, the delivery of urological services globally has quickly shifted to telemedicine to account for the mass clinical, procedural, and operative cancellations, inadequate personal protective equipment, and shortage of personnel. OBJECTIVE The aim of this study was to investigate current telemedicine usage by urologists, urologists' perceptions on the necessity of in-person clinic appointments, the usability of telemedicine, and the current barriers to its implementation. METHODS We conducted a global, cross-sectional, web-based survey to investigate the use of telemedicine before and after the COVID-19 pandemic. Urologists' perceived usability of telemedicine was assessed using a modified Delphi approach to create questions based on a modified version of the validated Telehealth Usability Questionnaire (TUQ). For the purposes of this study, telemedicine was defined as video calls only. RESULTS A total of 620 urologists from 58 different countries and 6 continents participated in the survey. Prior to COVID-19, 15.8% (n=98) of urologists surveyed were using telemedicine in their clinical practices; during the pandemic, that proportion increased to 46.1% (n=283). Of the urologists without telemedicine experience, interest in telemedicine usage increased from 43.7% (n=139) to 80.8% (n=257) during the COVID-19 pandemic. Among urologists that used telemedicine during the pandemic, 80.9% (n=244) were interested in continuing to use it in their practice. The three most commonly used platforms were Zoom, Doxy.me, and Epic, and the top three barriers to implementing telemedicine were patients' lack of technological comprehension, patients' lack of access to the required technology, and reimbursement concerns. CONCLUSIONS This is the first study to quantify the use, usability, and pervading interest in telemedicine among urologists during the COVID-19 pandemic. In the face of this pandemic, urologists' usage of telemedicine nearly tripled, demonstrating their ability to adopt and adapt telemedicine into their practices, but barriers involving the technology itself are still preventing many from utilizing it despite increasing interest.
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Affiliation(s)
- Justin M Dubin
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - W Austin Wyant
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Navin C Balaji
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - William Lk Ong
- Department of Urology, Penang General Hospital, Penang, Malaysia
| | - Reda H Kettache
- Department of Urology, Bachir Bennacer - Biskra Hospital, Biskra, Algeria
| | - Malik Haffaf
- Department of Urology, EHU 1er Novembre, Oran, Algeria
| | - Skander Zouari
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Diego Santillan
- Department of Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Ana Maria Autrán Gómez
- Department of Urology, Hospital Universitario Fundación Jiménez Diaz, Madrid, Spain
- Research Office of Confederacion Americana de Urologia, Buenos Aires, Argentina
| | - Hossein Sadeghi-Nejad
- Department of Urology, Rutgers New Jersey Medical School, Newark, NJ, United States
- Department of Urology, Hackensack Meridian Health, Hackensack, NJ, United States
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs Medical Center, New York City, NY, United States
| | - James F Borin
- Department of Urology, New York University, New York City, NY, United States
| | - Juan Gomez Rivas
- Department of Urology, La Paz University Hospital, Madrid, Spain
- Department of Urology, Autonomous University of Madrid, Madrid, Spain
| | - Jeremy Grummet
- Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia
| | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Jeremy Y C Teoh
- SH Ho Urology Centre, Prince of Wales Hospital, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
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10
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A new role for orthopaedic surgeons: ongoing changes, lessons learned, and perspectives from a level I trauma center during the COVID-19 pandemic. J Shoulder Elbow Surg 2020; 29:1951-1956. [PMID: 32738400 PMCID: PMC7390768 DOI: 10.1016/j.jse.2020.07.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 07/24/2020] [Accepted: 07/25/2020] [Indexed: 02/01/2023]
Abstract
The COVID-19 pandemic has redefined global health care. With almost 13 million confirmed cases worldwide, medical professionals have been forced to modify their practice to take care of an expanded, critically ill population. Institutions have been challenged to implement innovative ways to maximize the utility and the safety of residents and personnel. Guided by lessons learned from prior mass causalities, wars, and previous pandemics, adjustments have been made in order to provide optimal care for all patients while still protecting limited resources and the lives of health care workers. Specialists who are trained in the management of lethal aspects of this disease continue to have a high demand and obvious role. Orthopedic surgeons, with ill-defined roles, have been redeployed to manage complex medical problems. Still, the need to manage trauma, fractures, infections, tumors, and dislocations remains a necessity. Various innovative measures have been taken to maximize the utility and safety of residents in the inpatient and outpatient setting. Commonalities to most measures and distinct changes in practice philosophy can be identified and applied to both current and future pandemic responses.
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Kumar S, Kumar A, Kumar M, Kumar A, Arora R, Sehrawat R. Feasibility of telemedicine in maintaining follow-up of orthopaedic patients and their satisfaction: A preliminary study. J Clin Orthop Trauma 2020; 11:S704-S710. [PMID: 32837105 PMCID: PMC7395587 DOI: 10.1016/j.jcot.2020.07.026] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/17/2020] [Accepted: 07/24/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The current COVID-19 pandemic has implications on the morbidities of orthopedic patients due to lack of routine follow-ups, and inpatient and outpatient-based interventions. Telemedicine has recently emerged as an alternative for healthcare delivery to the patients and providing them with important information about orthopedic self-care and medications that can be followed without a hospital visit. However, due to lack of physical assessment, telemedicine is bound to have some limitations as well. The aim of this study is to analyze the effectiveness of proactive telemedicine in maintaining follow-up of orthopedic patients, and their satisfaction with telemedicine as an alternative mode of treatment delivery. METHODS This one-month cross-sectional study enrolled the follow-up patients that visited the orthopedic outpatient-department in February 2020. The patients were sequentially called according to the order of their registration, on a daily basis. Consenting patients were provided with telemedicine-based consultations, and those requiring physical evaluation were called for outpatient visits after documenting the valid reasons. The response-rates and the volume of patients requiring physical visits were measured for different diagnosis-based groups. Patients were asked to complete a questionnaire that included overall patient satisfaction with telemedicine, its effectiveness, and ease in following the telemedicine-based treatment. RESULTS The response rate to telemedicine was 88.67%. Among the patients availing telemedicine, 71.43% were managed without needing physical visits to the outpatient-department. The need for physical examination and failed patient-doctor communication were the most common reasons for advising physical outpatient visits. The overall satisfaction-rate to telemedicine was 92%, and only 7.2% of patients had difficulty in understanding or following telemedicine-based advice. CONCLUSIONS Telemedicine can effectively reduce the need for physical visits to outpatient-departments for follow up of orthopedic patients. The response-rate and overall patient-satisfaction rates to telemedicine are high. Further efforts in expanding the use of telemedicine and addressing its limitations, especially those related to the failed communications, are needed to develop it as an alternative to physical orthopedic consultations in the current situation.
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Affiliation(s)
| | - Arvind Kumar
- Department of Orthopaedics, HIMSR, New Delhi, India,Corresponding author. Department of Orthopaedics, HIMSR, New Delhi, India.
| | - Mukesh Kumar
- Department of Orthopaedics, HIMSR, New Delhi, India
| | - Ashok Kumar
- Gastroenterology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Rajesh Arora
- Department of Orthopaedics, HIMSR, New Delhi, India
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